Covid -19 vs other infection stats.

[MarkDv]

I thought it should be discussed previously but I checked posts for the last year and didn't find anything related..
Now, after about a year of the pandemic, the number of deaths from Covid-19 in the world is about 1.9 million.
However 3.9 million died in 2002 from lower respiratory tract infections.
From hepatitis C and B, not counting the rest (but there is much less) in 2015/2016, almost 1.3 million died.
https://en.wikipedia.org/wiki/Infection
https://www.who.int/news-room/fact-sheets/detail/hepatitis-c
https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
And there was not much fuss about it. ...
Well, let's say that Covid added another 2 million to these 3.9 million deaths from pneumonia (although this is unlikely to be the case, because those who die from Covid still had a very high chance of dying from another pneumonia, so the figure for non-Covid pneumonia should be less for this period) .... 
But still, it does not fit with the data on overcrowded hospitals, etc.
Strange…
Now in Russia officials say that there is almost no influenza during this season (Autumn-Winter) other than Covid-19…
https://tass.ru/obschestvo/10466859 (in Russian)
I am by no means a conspiracy theorist and I do not consider this pandemic a fake event, but still seems strange to me ...
Any suggestion/explanations?

Thanks!
 

[swansont]

10 minutes ago, MarkDv said:

But still, it does not fit with the data on overcrowded hospitals, etc.
Strange…

Number of people in hospital ≠ number of deaths 

If e.g. 20% of hospitalized patients die, then the occupancy is 5x higher than the deaths. And the length of stay matters, too.

And AFAIK it’s ICU capacity, specifically, that’s being strained. Do these other afflictions result in an ICU stay?

[MarkDv]

Yes, I agree that

Quote

Number of people in hospital ≠ number of deaths 

But why do you think that Covid-19 course of disease is different from other influenza?
It's much more logical ( I think... may be wrong...) to assume that those 3.9 ml died in 2002 just simply died at home without intensive care which people with Covid-19 are getting now due to very high social attention.
I don’t have depth stats for 2020 but I would not be surprised if the depth toll related to influenza/pneumonia is actually less than normal due to the fact that many people are saved in the hospitals (who were dying with the same conditions in previous years)
Again I’m not trying to impose anything, I'm just trying to understand the info I found accidentally...

[CharonY]

15 minutes ago, MarkDv said:

But why do you think that Covid-19 course of disease is different from other influenza?

A) there is no immunity for COVID-19. For Influenza we have endemic immunity plus vaccinations. Still thousands die each year from influenza, more have died from COVID-19. If we let it fully sweep through the population, far more will die.

B) Many of the infections you mention are chronic infections. I.e. many live for years with the disease and the deaths in any year are often the cumulation of many years of infections. The death of COVID-19 is the consequence of infections in a single year.

C) Specific to lower respiratory tract infections, they are also often connected to things like allergies, air pollution and a whole range of different diseases. If COVID-19 would be added we would see about a 50% increase from a single virus. This is enormous.

 

[studiot]

19 minutes ago, MarkDv said:

gain I’m not trying to impose anything, I'm just trying to understand the info I found accidentally...

Seems to me you are trying to be sensationalist about it.

 

Here are some (published and easily verified) facts.

Over the last week or so the number of cases of C-19 in the UK has been running about 36,000 per day and the death rate at about 600 per day.

So the death rate at the moment is about 1.5 - 2 % of those contracting the condition.

What do you think the death rate for those contracting the common cold or influenza is ?

Secondly the medical care required for these patients is such that the stay in hospital is longer than for most conditions and, of course, most influenza/cold cases do not require hospitilisation.
The combined effect of these two factors mean that they have displaced treatements for other conditions, eg cancer, so that this time last year there were 150,000 outstanding hospital treatments, today there are 60 million. (reported in the last few days on the BBC)

5 minutes ago, CharonY said:

If COVID-19 would be added we would see about a 50% increase from a single virus. This is enormous.

That figure is consistent with UK published figures.

The result of my last comment leads to the count of so  called 'excess deaths', which has been running between 150% and 200% of the recorded C-19 deaths.

[CharonY]

1 minute ago, studiot said:

What do you think the death rate for those contracting the common cold or influenza is ?

One should add that one has to be carful with comparison (raw) death rates. A big issue with influenza, COVID-19 and other diseases that can have mild outcomes is that only a part of infected people actually get tested. While there are estimates, it can influence the the final death rate quite a bit. Also, as we have seen, overtaxing the health system can skyrocket the death rate. But as a whole, you are absolutely correct that as a whole (including the strain on the health care system, which can cause additional death) is far more dangerous as the "regular" flue season, which all by itself is pretty bad as it is.

6 minutes ago, studiot said:

The result of my last comment leads to the count of so  called 'excess deaths', which has been running between 150% and 200% of the recorded C-19 deaths.

Yes, that is a measure that some folks focus a bit more to indicate the compound effect of the pandemic. And it has clearly a spike in 2020 compared to previous years. Especially in the disease has shown to affect even big composite measures such as life expectancy. 

On top of all that I probably should add that there is now more work looking at post-acute COVID-19 syndrome, as there is more and more data that folks, even those with mild symptoms, may suffer long-term issues which get worse long after the infection has passed.

I think at this point there is really no arguing about how bad the disease is. It is really bad.

[studiot]

5 minutes ago, CharonY said:

One should add that one has to be carful with comparison (raw) death rates. A big issue with influenza, COVID-19 and other diseases that can have mild outcomes is that only a part of infected people actually get tested. While there are estimates, it can influence the the final death rate quite a bit. Also, as we have seen, overtaxing the health system can skyrocket the death rate. But as a whole, you are absolutely correct that as a whole (including the strain on the health care system, which can cause additional death) is far more dangerous as the "regular" flue season, which all by itself is pretty bad as it is.

I feel sure that in a mature regular society somone will have done the research.

We know the population we can poll the average number of colds/flu bouts each person has and we can compare this with the number of case of death where either of these conditions are recorded on the death certificate as a major cause.

I am also sure that digging out this data will reveal just how low the incidence of death from these causes really is.

Edited January 18, 2021 by studiot

[CharonY]

2 minutes ago, studiot said:

I feel sure that in a mature regular society somone will have done the research.

Oh, we do have estimates following a range of different assumptions and models. But they can lead to significantly different estimates in terms of death rates. I.e. the death rate always has a certain range of uncertainty which makes it only a moderately useful metric in many instances.

[studiot]

A statement on a UK death certificate is neither an assumption nor a model.

There will always be some human errors, but the incidence of these is miniscule.

[CharonY]

40 minutes ago, studiot said:

A statement on a UK death certificate is neither an assumption nor a model.

There will always be some human errors, but the incidence of these is miniscule.

Yes, but not everyone that dies will have a test performed (potentially for COVID-19 but certainly not for all diseases). Some folks may die from pneumonia, for example but it is not clear whether it was caused by an influenza infection, or not (folks are more wary of COVID-19 and may test more now, but it was not the case early last year). Similarly you may have a lot of folks that had the disease but were not tested (which is a big issue with COVID-19). So the death rate is typically just the fraction of diagnosed cases who eventually die. Yet many think of it as the fraction of deaths as a fraction of total infections. 

For example, if there were much more asymptomatic cases than current diagnostics indicate (i.e. the true total infection rate was higher than measured), then the COVID-19 death rate might drop as low as 0.1%, yet it clearly would underestimate the health burden it poses. And conversely, deaths that were not properly coded (because they were not tested) or missing infections could increase it. 

Also, the case fatality rate also changes depending on condition (it was way as high as 31% in Italy). So again, one needs to use the metric in the proper context. At best, it is a very crude measure of how bad a disease is. 

[MarkDv]

19 hours ago, studiot said:

Seems to me you are trying to be sensationalist about it.

This type of comments deprives me of the opportunity to say anything other than agreeing with all of the above.

Thank you everybody for the attention to my question!

[studiot]

21 hours ago, MarkDv said:

But still, it does not fit with the data on overcrowded hospitals, etc.
Strange…
...
I am by no means a conspiracy theorist and I do not consider this pandemic a fake event, but still seems strange to me ...
Any suggestion/explanations?

 

1 hour ago, MarkDv said:

This type of comments deprives me of the opportunity to say anything other than agreeing with all of the above.

Thank you everybody for the attention to my question!

 

Reviewing your opening post I see that I did not give enough prominence to your actual question in my answer.

Which is just how much of our NHS resources are being diverted by C-19 because of how long those patients who need hospital spend there

All this week the BBC news cameras are following events in the Royal London Hospital, where they also went at the start of the pandemic.

The RLH is a small 500 bed distict hospital in the middle of the East End of London.

In normal times they have 40 odd intensive care beds, counted into the 500.

Yesterday (Monday) it was reported that of the 500 beds over 490 were occupied by a 'high dependency' covid patient.

Some of these will still be there months later.

So what about the other 450 odd displaced would be patients ?

 

21 hours ago, CharonY said:

Oh, we do have estimates following a range of different assumptions and models. But they can lead to significantly different estimates in terms of death rates. I.e. the death rate always has a certain range of uncertainty which makes it only a moderately useful metric in many instances.

This phenomenon also affects your interpretation of figures.

The figures I was quoting were the daily new infections set against the daily deathis within 28 days of testing positive for C-19.

This gives a good estimate of your chance of dying from C-19 if you caught it today.

It would be false accounting to count in the number or % in the population with C-19 at any one time since the condition lasts a long time and you do not catch it every day.

Here are some figures on that just released by the Office for National Statistics.

https://www.bbc.co.uk/news/health-55718213

 

[CharonY]

1 hour ago, studiot said:

The figures I was quoting were the daily new infections set against the daily deathis within 28 days of testing positive for C-19.

This gives a good estimate of your chance of dying from C-19 if you caught it today.

That still does not seem to address the issue of undetected infection. The rate gives you a good idea to die from COVID-19 if you are tested positive. Obviously, the more folks are tested, the more these two values converge. 

But you are right, it is an estimate for death by being diagnosed with the disease at a given point in a given area.

[Oberon245]

On 1/18/2021 at 12:09 PM, CharonY said:

A) there is no immunity for COVID-19. For Influenza we have endemic immunity plus vaccinations. Still thousands die each year from influenza, more have died from COVID-19. If we let it fully sweep through the population, far more will die.

B) Many of the infections you mention are chronic infections. I.e. many live for years with the disease and the deaths in any year are often the cumulation of many years of infections. The death of COVID-19 is the consequence of infections in a single year.

C) Specific to lower respiratory tract infections, they are also often connected to things like allergies, air pollution and a whole range of different diseases. If COVID-19 would be added we would see about a 50% increase from a single virus. This is enormous.

 

As many as 45% (quite possibly more) of cases are entirely asymptomatic. Doesn't that qualify as immunity?

It appears to me that we lack accurate measurements/ support for the following:

- the mortality rate including the actual death count

- an accurate measure of the case rate / number of infections

- valid science in support of the general US pandemic response

 

If anyone could provide this information, I would be grateful. 

[CharonY]

1 hour ago, Oberon245 said:

As many as 45% (quite possibly more) of cases are entirely asymptomatic. Doesn't that qualify as immunity?

 

No, as asymptomatic cases can still produce enough viral titer to be tested positive and spread the infection. The massive spread and susceptibility in the population is the reason why we have so many deaths ( as I have mentioned above).

1 hour ago, Oberon245 said:

It appears to me that we lack accurate measurements/ support for the following:

- the mortality rate including the actual death count

- an accurate measure of the case rate / number of infections

- valid science in support of the general US pandemic response

Perfect data is a challenge for any disease. However for this one we do have a ton of data with a range of supporting estimates. But note that death rate is heavily influenced by a lot of parameters, such as availability and access to emergency treatment, oxygen, ventilators and so on. As such there is a wide range of estimates, depending on where you are. I.e. there is not a singular estimate satisfying all criteria or uses. 

In other words, it depends on what you want to figure out. If the goal is to compare to, say influenza, it is going to be difficult as influenza is usually highly underreported and often relying on indirect measures (e.g. absence from work) to estimate the actual outbreak numbers.

There are also different measures that one need to distinguish- the case fatality rate. I.e. how many of folks tested positive ultimately die. That, of course depends on how well we test the population. The infection fatality rate relies much more on estimating the the total rate of infections. The ranges even for established diseases such as influenza have several order of magnitude differences in range (again, because the actual known infected proportion is generally not known).But COVID-19 makes things even worse- there is also the risk of long-term damages, i.e. folks might indirectly die from the disease quite a bit off in the future. 

As it turns out, case of infection mortality alone is probably not a great measure to characterize a disease- it ignores for example the proportion of susceptible people. This is why in the USA alone we have more COVID-19 linked deaths than in the whole world for the H1N1 pandemic. Moreover, I see mortality rates frequently misused in the media (one way or a another). But as mentioned above, we now have a single disease which has been verified to cause as much deaths as all other lower respiratory infections combined. It is a single virus that worldwide ranks somewhere in the top 5 of causes of deaths. In the USA, COVID-19 is the third leading cause (or higher) of death for folk above 45. Between 35-44 it is about as lethal as transport accidents (but double as high as homicide). Influenza an pneumonia generally is only around the top 9 and only for groups older than 65. Again, it is a single disease that significantly alters the death statistic of the population. 

With regard to the response, I think at this point it is clear that countries that fail to have a centralized, updated pandemic plan or, if they have one did not act on it (recent reports have highlighted the issues in Italy) suffered more excess deaths and have resulted in higher circulation of viruses. The latter is also the cause for the emergency of new variants, and which makes it more likely that COVID-19 might become an endemic disease.